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I am currently writing an ethics assignment relating to a paediatric placement I undertook earlier this academic year. During the placement I was involved in the care of 11-month old twins from Khartoum, Sudan, whose parents had brought them into hospital because they were suffering from recurrent generalised tonic-clonic (grand mal) siezures. As part of their treatment, they were administered with intravenous antiepileptic medications, as well as maintenance fluids. The day after their admission, however, the family were informed that their application for leave to remain in the UK had failed, and that they were to return to the Sudan with immediate effect.

I would like to use this scenario to highlight the ethical, legal and professional issues raised by the medical treatment of failed asylum seekers on the NHS. The reason I am contacting you is to ask whether, as an expert in medical ethics, you are aware of any textbooks or published documents which may offer some guidance on this issue? Given the highly specific nature of the subject, I know the best I can hope for is a chapter in an ethics textbook, but the hospital and University libraries I have visited have not yielded any results; furthermore, I am afraid the internet simply does not seem to contain many credible sources of information.

This looks like a really interesting – and important – study; but I have to admit that the best I could do was to recommend a trawl of the journals.

Does anyone out there have any more specific suggestions? It’d be much appreciated if you’d leave them in the comments.

sorry, but as 'failed asylum seekers' – (although how they can call themselves asylum seekers from the Sudan – Britian is not exactly the closest 'safe country'), our National Health Service has no obligation whatsoever to rpovide any treatment at all. Forget ethics – it is a UK Service for UK People – not some worldwide free service hat anyone from anywhere can use as they wish. In fact – why you treated them at all free of charge is beyond me, and i would like to know who approved this treatment be provided. There are enough funding cuts preventing treatment for those of us that have paid in for 40+ years without giving free services to people with no legitimate rights to receive it.

Just out of curiosity: suppose you were a medic and someone was brought into hospital suffering from seizures. Would you really only treat them if they could first provide proof of their citizenship status?

I fear your answer to this may be… Oh, hang it. It's enough to say that I fear your answer.

John O'Malley

Oh dear! Mention asylum seekers and it pours out.Ok bit by bit.Asylum does not necessarily have to be in the next country. German Jews in the 30s would have been not shown the best of common sense if they had traipsed into Poland seeking asylum.Erm…..hate to disappoint but the NHS has a statutory obligation to treat asylum seekers as they are considered to be ordinarily resident in the UK. If they lose their claim and all appeal processes are lost, they lose entitlement to routine NHS primary care treatment but not emergency care, Even then LMC policy is that GPs should continue treatment until they leave the country.The NHS is not just for UK people but treats all if they are seen in an A&E setting and for other categories of care. For residents of the EU, all forms of treatment are available regardless how long they are resident here for.We also have reciprocal care arrangements with many other countries who also provide free care to our residents who visit their countries.What it doesn't do is provide free care for people who have retired and are living abroad and are designated foreign residents but pop back every so often so they can get 6 month prescriptions.As part of the massive NHS budget , the treatment of asylum seekers makes up a tiny percentage and I am sorry, Gazzer, it is about ethics or morality. We have a moral duty to care for people in an acute medical emergency whether they come from Sudan or Bognor Regis. No hospital would check someone's citizenship in such a case. I have been trained by the NHS and I am old enough to have had my tuition fes paid for by the State. So does that mean if someone collapses in front of me in front of the Reichstag, I walk away? Yes, we have to be careful it is not being abused by people who can well afford healthcare in their own country but it would be a strange country that shut the doors on people in need.